Symptoms of posttraumatic stress disorder and depression among children in Tsunami-affected areas in Southern Thailand. Journal of the American Medical Association, 296(5), 549-559

University of California, Los Angeles, Los Ángeles, California, United States
JAMA The Journal of the American Medical Association (Impact Factor: 35.29). 09/2006; 296(5):549-59. DOI: 10.1001/jama.296.5.549
Source: PubMed


On December 26, 2004, an undersea earthquake occurred off the northwestern coast of Sumatra, Indonesia. The tsunami that followed severely impacted all 6 southwestern provinces of Thailand, where approximately 20,000 children were directly affected.
To assess trauma experiences and the prevalence of symptoms of posttraumatic stress disorder (PTSD) and depression among children in tsunami-affected provinces in southern Thailand.
Population-based mental health surveys were conducted among children aged 7 to 14 years in Phang Nga, Phuket, and Krabi provinces from February 15-22, 2005 (2 months posttsunami), and September 7-12, 2005 (9 months posttsunami).
Trauma experiences and symptoms of PTSD and depression as measured by a tsunami-modified version of the PsySTART Rapid Triage System, the UCLA PTSD Reaction Index, and the Birleson Depression Self-Rating Scale.
A total of 371 children (167 displaced and living in camps, 99 not displaced from villages affected by the tsunami, and 105 not displaced from unaffected villages) participated in the first survey. The prevalence rates of PTSD symptoms were 13% among children living in camps, 11% among children from affected villages, and 6% among children from unaffected villages (camps vs unaffected villages, P = .25); for depression symptoms, the prevalence rates were 11%, 5%, and 8%, respectively (P = .39). In multivariate analysis of the first assessment, having had a delayed evacuation, having felt one's own or a family member's life to have been in danger, and having felt extreme panic or fear were significantly associated with PTSD symptoms. Older age and having felt that their own or a family member's life had been in danger were significantly associated with depression symptoms. In the follow-up survey, 72% (151/210) of children from Phang Nga participated. Prevalence rates of symptoms of PTSD and depression among these children did not decrease significantly over time.
This assessment documents the prevalence of mental health problems among children in tsunami-affected provinces in southern Thailand at 2 and 9 months posttsunami. Traumatic events experienced during the tsunami were significantly associated with symptoms of PTSD and depression. These data may be useful to target mental health services for children and may inform the design of these interventions.

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Available from: Frits van Griensven, Apr 02, 2014
    • "After the devastating tsunami that struck Asian and African coastlines on 26 December 2004, several articles reported psychiatric consequences, particularly post-traumatic stress disorder (PTSD) among children and adolescents (Jensen, Dyb and Nygaard, 2009; John, Russell and Russell, 2007; Kristensen, Weisaeth and Heir, 2009; Neuner, Schauer, Catani, Ruf and Elbert, 2006; Piyasil et al., 2007; Thienkrua et al., 2006; Ularntinon et al., 2008). PTSD can lead to substantial functional impairments. "
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    ABSTRACT: Post-traumatic stress disorder (PTSD) is a common and debilitating consequence of natural disaster in children and adolescents. Accumulating data show that cognitive behavioural therapy (CBT) is an effective treatment for PTSD. However, application of CBT in a large-scale disaster in a setting with limited resources, such as when the tsunami hit several Asian countries in 2004, poses a major problem. Aims: This randomized controlled trial aimed to test for the efficacy of the modified version of CBT for children and adolescents with PSTD. Method: Thirty-six children (aged 10–15 years) who had been diagnosed with PSTD 4 years after the tsunami were randomly allocated to either CBT or wait list. CBT was delivered in 3-day, 2-hour-daily, group format followed by 1-month posttreatment self-monitoring and daily homework. Results: Compared to the wait list, participants who received CBT demonstrated significantly greater improvement in symptoms of PTSD at 1-month follow-up, although no significant improvement was observed when the measures were done immediately posttreatment. Conclusions: Brief, group CBT is an effective treatment for PTSD in children and adolescents when delivered in conjunction with posttreatment self-monitoring and daily homework.
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    • "From a general psychopathology perspective, 9.3% of 4–17-year-old children were described as experiencing a “serious emotional disturbance” 18–27 months after Hurricane Katrina (McLaughlin et al., 2009). This is consistent with large sample cross-sectional research following a range of different disasters that has reported approximately 5–15% of children experience significant mental health symptoms following disaster exposure (McDermott & Palmer, 1999; Roussos et al., 2005; Shaw, Applegate, & Schorr, 1996; Thienkrua, Cardozo, Chakkraband, Guadamuz, & Thailand Post-Tsunami Mental Health Study Group, 2006; Vernberg, Silverman, La Greca, & Prinstein, 1996). Posttraumatic stress (PTS) symptoms have been frequently reported: 6 and 57% of children exposed to the 2004 Tsunami disaster experienced significant PTS symptoms (Thienkrua et al., 2006; Wickrama & Kaspar, 2007); 35% of children exposed to hurricanes (La Greca, Silverman, Lai, & Jaccard, 2010) and 4.5–95% of children exposed to earthquakes (Eksi & Braun, 2009; Roussos et al., 2005). "
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    Full-text · Article · Jul 2014 · European Journal of Psychotraumatology
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    • "Children and adolescents tend to be the most vulnerable members of communities affected by natural disasters and are particularly prone to resulting mental disorders [6]. Developing in the weeks and months following the traumatic event, the severity of their psychological symptoms vary as a function of their level of exposure to the event, loss of loved ones, personal injury, level of parental support and sense of dislocation [7]. Once established, the mental disorders can produce a range of consequences including relationship difficulties, poor educational and vocational outcomes, recurrent illnesses and substance abuse. "
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    Full-text · Article · Apr 2014 · The Journal of Physiological Sciences
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